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An Enhanced Simulation Can Show Occupational and Physical Therapy Students How People Adapt to Disabilities

What was this research about?

Occupational therapists (OT’s) and physical therapists (PT’s) to help them maximize their function and abilities to do activities they value. During their education, it is important that future OT’s and PT’s learn about the quality of life that people with disabilities may expect, and what supports they may find useful. Disability simulation is one technique for teaching students what it is like to have a disability. During a disability simulation, a student might be asked to use a wheelchair for a short time, or perform daily activities without use of one or both hands.

These simulations can be controversial: They are fun and memorable for students, but if not done carefully, they could frustrate students or give them an exaggerated sense of how difficult it is to live with a disability. This can happen if, for instance, a student is asked to spend a day in a wheelchair, without receiving instruction on how to operate the wheelchair efficiently. In this research, we tested a special “enhanced” simulation to teach OT and PT students about the tools that people with physical disabilities use in their everyday lives, instead of just having them pretend to have a disability. The simulation was set up to give students a chance to practice using common assistive devices. We wanted to find out whether this type of disability simulation could lead the students to have more positive beliefs about quality of life with a physical disability.

What did the researchers do?

We had 14 OT students and 18 PT students join our study. Half of the students did an “enhanced simulation” activity, while the other half of the students watched videos instead. The students who did the enhanced simulation participated in two hands-on exercises. First, they simulated loss of movement in their legs (paraplegia) and learned how to transfer from a chair into a wheelchair using their upper body with the “hop-over” method, and they learned to unlock the wheelchair and steer it across the room. Then, they simulated a loss of movement in their dominant hand (hemiplegia) and learned to make a sandwich without use of their dominant hand. They used assistive devices like a jar opener, gripper, and an angled knife to aid them in making the sandwich. We worked with each student individually to help him or her feel comfortable with the equipment, and all of the students successfully figured out how to navigate in the wheelchair and make the sandwich. As a comparison, the other half of the students watched videos of people with paraplegia and hemiplegia demonstrating the hop-over transfer and making the sandwich using the same equipment.

Before and after the study session, we surveyed all of the students and asked them to estimate the quality of life that people with paraplegia and hemiplegia experience on average. First, we asked them to guess what percentage of people with each disability would describe their overall health as good or excellent. Then we asked them to guess how high the average person with each disability would rate their overall life satisfaction. Finally, we asked them to guess the percentage of people with each disability who experience clinical depression. We looked at how much these estimates changed for the students who did the enhanced simulation vs. for those who watched the videos.

What did the researchers find?

The students rated average quality of life higher for people with paraplegia and hemiplegia after doing the simulation than before. They estimated that more people with both disabilities would consider themselves healthy and that less of them would be depressed. However, the students who watched the videos did not change their ratings much.

How can you use this research?

If students have the chance to practice using assistive equipment, they may better understand how people with physical disabilities can lead happy, satisfying lives. To achieve this goal, you can design learning activities that:

Give students time to explore the equipment and feel comfortable using it.

Offer hands-on demonstrations and instruction in how to use the equipment.

Include hands-on tasks that are challenging, but simple enough that students can master the tasks with some practice.

Include people with disabilities in developing and running the activities.

Things you should know:

Disability simulations can complement other teaching approaches, like having students work with standardized patients.

Disability simulations can be developed to highlight solutions, rather than problems.

The contents of our website were developed under a grant from National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90RT5023-01-00). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this website do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government (Edgar, 75.620 (b)).